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Chest Feminization Surgery is Associated with Objective Improvement in Gender Incongruence and Chest Satisfaction
Sheuli Chowdhury
*, Katherine G. Stark, Subha Karim, Sahil Sharma, Peter J. Taub, Elan Horesh, Peter W. Henderson
Division of Plastic and Reconstructive Surgery, Department of Surgery, Icahn School of Medicine at Mount Sinai, New York City, NY
Background: Chest feminization surgery (CFS) aims to alleviate gender incongruence and improve satisfaction with chest appearance. While anecdotally, CFS improves these important and distinct psychosocial measures, quantitative confirmation of this is still lacking to date, particularly regarding gender incongruence. This study sought to objectively assess the effects of CFS on gender incongruence and chest satisfaction using validated surveys.
Methods: Patients undergoing CFS were prospectively recruited from a single institution between 2022 and 2025. Surveys were administered preoperatively and up to 12 months postoperatively, with the latest survey score used as the postoperative value. Gender incongruence was measured via the validated Gender Minority Stress and Resilience (GMSR-NonAff/IntTrPh) survey with higher score indicating greater gender incongruence (5-point Likert scale, range 0-56). Satisfaction was measured via the validated Affirming Surgery Form and Function Individual Reporting Measure (AFFIRM) survey with lower score indicating greater satisfaction (5-point Likert scale, range 4-20). Shapiro-Wilk test confirmed non-parametric distribution, and Wilcoxon signed-rank test assessed paired score differences. Statistical significance was set at p<0.05.
Results: A total of 38 patients who underwent CFS and completed a preoperative and postoperative survey were included. Median GMSR score decreased from 21 to 14 (n=36, Z=-2.52, p=0.012), indicating alleviation of gender incongruence after CFS. Median AFFIRM satisfaction score decreased from 13 to 5 (n=37, Z=-5.31, p<0.001), indicating improved chest satisfaction after CFS.
Conclusion: Chest feminization surgery is associated with objective alleviation of gender incongruence and improvement in satisfaction with chest appearance using validated surveys.
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